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Obesity is a Major Risk Factor for Hospitalization in Community-Managed COVID-19 Pneumonia.
Cottini, Marcello; Lombardi, Carlo; Berti, Alvise.
  • Cottini M; Pulmonology, Allergy & Clinical Immunology Outpatient Clinic, Bergamo, Italy. Electronic address: cottinimarcello@gmail.com.
  • Lombardi C; Departmental Unit of Pneumology & Allergology-COVID19 Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
  • Berti A; Ospedale Santa Chiara and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Italy; Thoracic Disease Research Unit, Mayo Clinic, Rochester, MN. Electronic address: alvise.berti@apss.tn.it.
Mayo Clin Proc ; 96(4): 921-931, 2021 04.
Article in English | MEDLINE | ID: covidwho-1062512
ABSTRACT

OBJECTIVE:

We aimed to investigate whether the stratification of outpatients with coronavirus disease 2019 (COVID-19) pneumonia by body mass index (BMI) can help predict hospitalization and other severe outcomes. PATIENTS AND

METHODS:

We prospectively collected consecutive cases of community-managed COVID-19 pneumonia from March 1 to April 20, 2020, in the province of Bergamo and evaluated the association of overweight (25 kg/m2 ≤ BMI <30 kg/m2) and obesity (≥30 kg/m2) with time to hospitalization (primary end point), low-flow domiciliary oxygen need, noninvasive mechanical ventilation, intubation, and death due to COVID-19 (secondary end points) in this cohort. We analyzed the primary end point using multivariable Cox models.

RESULTS:

Of 338 patients included, 133 (39.4%) were overweight and 77 (22.8%) were obese. Age at diagnosis was younger in obese patients compared with those overweight or with normal weight (P<.001), whereas diabetes, dyslipidemia, and heart diseases were differently distributed among BMI categories. Azithromycin, hydroxychloroquine, and prednisolone use were similar between BMI categories (P>.05). Overall, 105 (31.1%) patients were hospitalized, and time to hospitalization was significantly shorter for obese vs over- or normal-weight patients (P<.001). In the final multivariable analysis, obese patients were more likely to require hospitalization than nonobese patients (hazard ratio, 5.83; 95% CI, 3.91 to 8.71). Results were similar in multiple sensitivity analyses. Low-flow domiciliary oxygen need, hospitalization with noninvasive mechanical ventilation, intubation, and death were significantly associated with obesity (P<.001).

CONCLUSION:

In patients with community-managed COVID-19 pneumonia, obesity is associated with a higher hospitalization risk and overall worse outcomes than for nonobese patients.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Community Health Services / COVID-19 / Obesity Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Mayo Clin Proc Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Community Health Services / COVID-19 / Obesity Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Mayo Clin Proc Year: 2021 Document Type: Article